English HCAI and AMR data at your Fingertips

PHE have just launched an interactive database for HCAI and AMR data from England using their ‘Fingertips’ platform. The HCAI data in the module has been available for years, but was buried in pretty dense Excel spreadsheets so tricky to visualise. The Fingertips platform makes data extraction and visualisation so easy even I can do it (example below).

Figure: Trend in the rate of C. difficile infection at Imperial Hospitals.

As well as the individual pathognes that are reported to PHE on the mandatory scheme, data are available on antimicrobial resistance, antibiotic prescribing, and rate of ‘Antibiotic Guardians’. You can also cross-plot any two variables of interest (example below).

Figure: Rate of C. difficile plotted against rate of pip/tazo usage.

As with all publicly reported data, there is a risk of misinterpretation and misrepresentation of the data. You could look at the charts above and ask why Imperial’s C. difficile rate is consistently higher than the rate in the rest of England, or why the use of pip/tazo is relatively high. But these charts do not get across the complexity of patients cared for in large teaching hospitals, nor the variation in the protocols for collecting and testing specimens.

Combined with excellent interative database available through ECDC, we really do have important AMR-related indicators at our fingertips, which should help to drive improvements in patient care.

Coming from a hospital which is firmly on the ‘right’ side of the antibiotic prescribing divide on this data, I love it. Would be interested to hear what someone on the other side has to say about it. If this data is used as a starting point for discussion then great. If it’s used as an endpoint for ‘quality’ payments then we may see some seriously dysfunctional behaviour. The next year will be interesting. Is anyone studying how AMR programmes respond to this?

Coming from a hospital which is firmly on the ‘wrong’ side of the antibiotic prescribing divide, I love it too. It is vital to start benchmarking and performance managing ourselves in these important indicators. The only caveat being that there is a clear understanding that a ‘crude’ comparison of the same metrics between different hospitals may not be valid. Would be a good study to see how and to what extent AMR programmes are influenced.